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3 <br /> NOTE: PULL ALk..,ERMITS (Septic, Well, etc.) MAKI .]PIES FOR FILE <br /> 1. SEWAGE: <br /> Distance to Public Sewers: Connection Necessary ? ❑ Yes �No <br /> Does Existing Septic System comply with San Joaquin County Development Title? EyYes ❑ No F] Unknown <br /> If no,explain: <br /> Describe Septic System to be installed: <br /> 2. WATER SUPPLY: <br /> Is Water supplied by Private Well? dYes 0 No Is well properly sealed and constructed ? Yes F-1 No <br /> Describe deficiency,if any: <br /> Is well system a Public Water system? ❑ Yes ED"No Is Public Water System Permit current? Yes F-� No <br /> Does existing or proposed use make this a Public Water System? F-1 Yes E2/No <br /> Is water/well sampling current? ❑ Yes ❑ No <br /> Additional information or comments: <br /> 3. GARBAGE&REFUSE: <br /> Licensed scavenger pick-up? ❑ Yes ❑ No Service Area No. <br /> Other proposed disposal method: <br /> Potential Problem(s): <br /> 4. FLY,MOSQUITO OR VECTOR CONTROL: <br /> Describeotential Vector r Control issues: —) <br /> 5. TOILET/BATH FACILITIES: <br /> Number and Location(s)of existing facilities: Z <br /> Additional facilities required: <br /> b. PREVIOUS OPERATION HISTORY: <br /> 7. GENERAL SANITATION: <br /> List any problem(s)not previously noted: 4k - <br /> S. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br /> EH 06 06 Report#7201 <br /> July 23,2010 <br />